Women and Anxiety

Of all the things that have held me back and hurt me the most, anxiety is pretty high on the list. Those anxious thoughts that sometimes whisper, but most often scream, there’s something wrong — with me; with them; with this, that, or the other. I’ve known for a long time I’m not alone in this way of thinking. But it wasn’t until recently that I learned most of the company I’m keeping is with women, as studies show women are twice as likely as men to experience anxiety. Here’s what we know about anxiety, women and anxiety, and what we can do about it.

What is anxiety?

Before we focus on women and anxiety, let’s take a closer look at anxiety itself:

Anxious: Troubled or uneasy in mind about some uncertain event; being in painful or disturbing suspense; concerned, solicitous. ~The Oxford English Dictionary1

That’s the closest any definition has come to fully describing how I feel when I’m experiencing anxiety.

Yes, I’m nervous, apprehensive, afraid. Yes, I’m tense, worried, and ill at ease. But it’s the “painful or disturbing suspense” description that really captures my mood and the intensity of perceived consequences — that when I’m anxious, everything seems to hinge on what’s on the other side.

Merriam-Webster also has a definition that resonates with me, though I want to comment on its “abnormal” reference. Anxiety is a normal emotion that all of us experience at one time or another. It crosses over into abnormal when it develops into an anxiety disorder.

Anxiety (medical): An abnormal and overwhelming sense of apprehension and fear often marked by physiological signs (as sweating, tension, and increased pulse), by doubt concerning the reality and nature of the threat, and by self-doubt about one’s capacity to cope with it. ~Merriam-Webster Dictionary

In other words, it may be unlikely to happen, but it very well could. And since I’m so ill-equipped to cope with it, I better prepare (i.e., worry) all I can, just in case.

As Dr. Edmund J. Bourne explains in The Anxiety and Phobia Workbook, the forms of anxiety can be broken down as follows (relevant to women and anxiety, as well as men):2

1) Free-floating anxiety

“Anxiety that is not connected with any particular situation, that comes ‘out of the blue,’ is called free-floating anxiety or, in more severe instances, a spontaneous panic attack.”3

2) Situational anxiety

“If your anxiety arises only in response to a specific situation it is called situational anxiety or phobic anxiety. Situational anxiety is different from everyday fear in that it tends to be out of proportion or unrealistic.”4

3) Anticipatory anxiety

“When you feel distressed about what might happen when or if you have to face one of your phobic situations, you are experiencing what is called anticipatory anxiety. In its milder forms, anticipatory anxiety is indistinguishable from ordinary ‘worrying.’ But sometimes anticipatory anxiety becomes intense enough to be called anticipatory panic.”5

Women and anxiety: Are we really more anxious than men?

The research on women and anxiety would certainly have us believe so, at least when it comes to anxiety disorders. Of particular interest to me is a recent study documented in The Stressed Sex, a 2013 book that analyzed mental health data from 12 national surveys.

Instead of relying on the diagnoses of patients in doctors’ offices or hospitals, authors Daniel Freeman and Jason Freeman analyzed surveys of the general population. They found 12 of them that fit the bill, all of which conclude the same thing about women and anxiety: anxiety disorders are more prevalent in women. 6

However, it is important to note that each of these surveys used a set of “established, reliable, and valid psychiatric interviews – by which we mean that the assessments can be trusted to produce the sort of conclusions that a clinician might arrive at were they to assess the participant in person based on DSM [Diagnostic and Statistical Manual of Mental Disorders] or ICD [International Classification of Diseases and Health Related Problems] criteria.”7

That’s important to note because of an important suggestion in The Stressed Sex:

It may be that diagnosis criteria for psychological disorders is gender-biased.8

“What does it mean if men’s and women’s experiences of a particular condition isn’t identical?” the authors write. “Should the criteria for that disorder be tweaked to accommodate the difference? Are men and women undergoing the same thing in diverse ways, or are they suffering from qualitatively distinct problems?”9

When it comes to women and anxiety, it could also be that women are simply more likely than men to talk about — and seek help for — their anxiety:10

“Probably the most significant reason why women get diagnosed with anxiety disorders twice as often as men isn’t that they’re doubly fearful,” writes author Taylor Clark for Slate. “It’s because anxious men are much less likely to seek psychological help…. If nearly twice as many women seek help from a psychologist, then they’ll obviously be diagnosed more often with anxiety disorders.”

Or, maybe women really do experience anxiety more than men, whether they are diagnosed disorders or not. In my research on women and anxiety, I came across all sorts of reasons for why this may be true:

1) Parents being more accepting of anxiety in girls than boys, in which case girls do not grow up with the same encouragement to face their fears and develop coping strategies1112

11) Career advancement and earning potential being more difficult for women than men23

12) Women avoiding standing up for themselves to ask for what they want and deserve24

While the question of whether all of this leads to more anxiety in women than men is an interesting one, what matters more to me on the subject of women and anxiety is acknowledging that women clearly face unique challenges that can cause anxiety – challenges we need to be talking about.

That alone is a big step in the right direction.

I know when I’m feeling anxious about something, building it up into monstrous proportions in my head, voicing my fears to someone else tends to bring them back down to a more manageable size.

What is the difference between anxiety and an anxiety disorder?

An anxiety disorder is more intense than normal anxiety, lasts longer, and generates symptoms that interfere with your daily life.25

I was diagnosed with generalized anxiety disorder in 2011. That’s when I started seeing a therapist for help with an unmanageable workload. Before starting therapy, I don’t think I even realized that what I was experiencing was anxiety. I just knew I couldn’t stand the stress, worry, and fear I felt in my work pretty much every day. Once I had a name for it, that’s when I realized I didn’t just feel this way about work. I started to recognize anxiety in most every area of my life.

Why do some of us develop anxiety disorders and others don’t?

Any number of things – in various combinations – cause some of us to be more susceptible to anxiety disorders than others. Some of these contributors were determined in the past, like:

As overwhelming as this list looks to me – as I can relate to nearly everything on it – I take comfort in two things: 1) Some of these causes are beyond my control, and 2) I have the power to change the rest.

How is anxiety fueled by mistaken beliefs and negative self-talk?

No resource on women and anxiety is complete without mention of how our anxiety is fueled by mistaken beliefs and negative self-talk. You may not actively contemplate your core beliefs about the world – or about yourself – but they color your every decision, every experience, and every relationship.

Unfortunately, many of these core beliefs, most learned early in life, are dead wrong. And they translate into negative self-talk that poisons your confidence and your goals:

I’m not pretty enough …

To be noticed

To get a date

To hold someone’s interest

I’m not lovable enough …

To make friends

To fall in love

To deserve forgiveness

I’m not powerful enough …

To stand up for myself

To get out of a bad situation

To get what I want

I’m not important enough …

To make a difference

To be remembered

To earn respect

I’m not smart enough …

To hold an intelligent conversation

To do a good job

To make it on my own

This list is by no means exhaustive. We have all sorts of ways of telling ourselves we are not enough. Unfortunately, core beliefs like these don’t change overnight. However, the negative self-talk perpetuating these beliefs can change today.

Next time you catch yourself having a negative thought about yourself, write it down, then counter it with positive self-talk instead.

Negative self-talk about the way I speak in social situations comes up for me a lot. Things along the lines of, “You’re being too quiet,” “You’re acting weird,” or “You’re sounding stupid.” The flip side? “You’re being a good listener,” “You’re being yourself,” “You’re saying what you mean.”

What are some ways to minimize anxiety?

The last thing you need when you’re trying to minimize anxiety is an anxiety-inducing to-do list. So please, do not think of this as a list of to-do’s, but a list of possibilities – what works for other people and what might work for you, too:

You need not try all or even most of these ideas. Just try what you’re drawn to now, keep doing what works, and be open to trying new things going forward.

How are anxiety disorders treated?

If you have an anxiety disorder – or think you might – please make an appointment to talk to a therapist or other healthcare professional about it, as anxiety disorders are serious mental illnesses. They are not uncommon, though – it’s estimated that 40 million American adults are living with one – and certainly nothing to be ashamed of.

Cognitive behavioral therapy (CBT) has proven extremely successful for most anxiety disorders, as have other therapies. In some cases, medications are prescribed, including anti-anxiety drugs, antidepressants, and beta blockers.

For my own generalized anxiety disorder, I have not been prescribed medication, but cognitive behavioral therapy has worked well. (That’s where I learned how to keep a worry journal, an especially powerful anxiety-reducing tool.) At the suggestion of my doctor, I’m also starting St. John’s Wort (a welcome outcome of the wellness exam I’d been dreading for years).

Get the help you need

While I hope this website is an informative and inspiring resource for you on the subject of women and anxiety, Plenty Woman is not intended to serve as, or replace, professional help for an anxiety disorder. Below is a list of other resources you may find helpful, particularly the Finding Help section of the ADAA website, as you can find a therapist and/or support group in your area.